Efficacy and safety of ultra rapid iron polymaltose infusion during general anaesthesia

Abstract

To assess the efficacy and safety of ultra rapid (15 minute) infusion of iron polymaltose to iron deficient patients during general anaesthesia, we performed a prospective, interventional non-randomised study on 99 adult patients with iron deficiency with or without anaemia presenting for surgery under general anaesthesia. Over 15 minutes during the maintenance phase of anaesthesia, patients were given iron polymaltose, 500 mg if not anaemic, or 1,000 mg if anaemic. Haemodynamic stability, immediate or delayed iron-related side-effects and efficacy at six weeks were assessed. The incidence of significant hypotension or the requirement for vasopressor was not different before, during or after the iron infusion. There were no serious intraoperative events (allergic reactions or skin staining). Mean (standard deviation, SD) haemoglobin rose from 121 (14) g/l preoperatively to 131 (12) g/l at six weeks (P <0.001). Mean (SD) ferritin rose from 17 (12) μg/l to 110 (83) μg/l by six weeks (P <0.001). At six weeks only four out of 64 contactable patients (6.25%) had a ferritin of <30 μg/l. The incidence of immediate or delayed side-effects was similar to patients undergoing outpatient iron polymaltose infusions and reflective of a post-surgical population. We conclude that up to 1,000 mg of iron polymaltose can be given over 15 minutes without significant haemodynamic compromise to selected patients undergoing general anaesthesia. Iron polymaltose administered in this way appears efficacious in treating iron deficiency.